title: A new technique for laparoscopic splenectomy and azygoportal disconnection.
abstract: BACKGROUND
  Laparoscopic splenectomy and azygoportal disconnection (LSD) using many different surgical techniques has become increasingly popular for treatment of cirrhotic patients with bleeding portal hypertension and secondary hypersplenism. Surgical procedures with the least possible impairment are consistently expected by both surgeons and patients. Here, we report a clinical cohort of 10 patients who underwent LSD with a new technique and present the advantages of less impairment during performance of this new technique.
  
  
  METHODS
  A cohort of 10 cirrhotic patients with bleeding portal hypertension and secondary hypersplenism treated with LSD were studied. During the procedure, an electromechanical morcellator allowed for easy extraction of the entire massive splenic tissue without a cumbersome intracorporeal bag, enlarged incision, or hand-assisted incision. Various perioperative data were recorded.
  
  
  RESULTS
  LSD was successful in all patients. There was no conversion to open operations or significant perioperative complications. The operative time was 288.0 ± 53.9 minutes, the spleen removal time was 39.3 ± 15.1 minutes, and blood loss was 240.0 ± 217.1 mL.
  
  
  CONCLUSIONS
  This new technique involving the use of an electromechanical morcellator provides expedient recovery and minimal postoperative pain and scarring. LSD with this technique is a feasible, effective, and safe surgical procedure, and embodies all the benefits of minimally invasive surgery for cirrhotic patients with bleeding portal hypertension and hypersplenism.
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Jiang
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Qian
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Yao
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China.
authors.forename: Shengjie
authors.initials: S
authors.lastname: Jin
authors.affiliation: Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China bdsno1@hotmail.com.
authors.forename: Dousheng
authors.initials: D
authors.lastname: Bai
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects / Q000379:methods*
keywords: azygoportal disconnection; laparoscopy; liver cirrhosis; morcellator; portal hypertension